Mineral Trioxide Aggregate (MTA) Applications & Luxation Injuries

Mineral Trioxide Aggregate (MTA) Applications

Pulp Therapy

• Pulp capping
• Furcation repair
• Strip perforation repair
• Root resorption repair
• Immature teeth
• Root end filling material

Elements of Pulp Regeneration

Therapy for exposed dental pulps using stem cells and a biofunctional scaffold, inhibiting or eliminating infection to facilitate pulp generation.

Nickel-Titanium (NiTi) Rotary Instruments

Advantages of NiTi Reciprocation

• Mimics manual movement
• Reduces risks associated with continuous rotation in curved canals

Types of Posts

1. Carbon fiber epoxy resin posts
2. Zirconia posts
3. Glass fiber reinforced posts
4. Ultra-high strength polyethylene fiber reinforced posts

Advantages of NiTi Rotary

• Gradual, evenly tapered radicular preparation
• Fewer instruments required
• Reduced treatment time
• Improved vision with handpiece use
• Less debris extrusion

Disadvantages of NiTi Rotary

• Difficult use in narrow canals, risk of instrument fracture
• Fracture can occur without warning
• High cost
• Rapid dulling
• Shape memory complicates posterior canal negotiation
• Loss of tactile sensation

NiTi Rotary Design Features

• Progressive taper
• Modified guiding tip
• Varying tip diameters
• Convex triangular cross-section
• Varying helical angle and pitch
• Shorter handle (15mm-12.54mm)
• Shaping files (S1, S2)
• Finishing files (F1, F2, F3)

Luxation Injuries

Trauma to the supporting tissues of the tooth.

Types of Luxation Injuries (in increasing order of severity)

Concussion

Minor injury to the periodontal tissue without tooth displacement or mobility.

Diagnosis and Clinical Presentation

• No displacement or mobility
• Pain to percussion (primary feature)
• History of recent trauma
• No bleeding from the gingival sulcus
• No radiographic signs of pathology
• Usually responds normally to vitality tests

Treatment

• Relief of occlusal interferences
• Soft diet for two weeks
• Periodic monitoring of pulp response

Subluxation

Slight injury to the periodontal tissue with slightly increased mobility.

Diagnosis and Clinical Presentation

• Slight tooth mobility
• Sulcular bleeding
• Sensitivity to percussion

Treatment

• Relief of occlusal interferences
• Soft diet for two weeks
• Periodic monitoring of pulp response
• Immobilization for two weeks for patient comfort

Extrusive Luxation

Tooth displacement in an outward direction.

Treatment

Atraumatic repositioning and fixation (2-3 weeks)

Lateral Luxation

Tooth displacement labially, lingually, distally, or incisally.

Treatment

• Local anesthetic administration
• Tooth repositioning
• Splinting

Intrusive Luxation

Tooth displacement apically into the alveolus.

Diagnosis and Clinical Presentation

• Tooth pushed into the socket
• Metallic sound on percussion
• Infra-occlusion

Treatment

Dependent on the stage of root development.